| 1. |
- Aaro Jonsson, Catherine, 1963-, et al.
(författare)
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Long-term cognitive outcome after neurosurgically treated childhood traumatic brain injury
- 2009
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Ingår i: Brain Injury. - : Taylor & Francis. - 0269-9052 .- 1362-301X. ; 23:13-14, s. 1008-1016
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore the cognitive long term outcome of two cohorts of patients neurosurgically treated for childhood traumatic brain injury (CTBI), either in 1987-1991 according to an older concept, or 1997-2001 with a stronger emphasis on volume targeted interventions. Research design and methods: Participants in the two cohorts were subject to an extensive neuropsychological assessment, 13.2 and 6.1 years post injury, respectively. In a between group design, assessment results of the two cohorts, n 18 and n 23, were compared to each other and to controls. Data were analyzed with multivariate analyses of variance. Results: Long-term cognitive deficits for both groups of similar magnitude and character were observed in both groups. Abilities were especially low regarding executive and memory function and verbal IQ. The cognitive results are discussed in terms of vulnerability of verbal functions and decreased executive control over memory-functions. Conclusions: There is a definite need for long term follow up of cognitive deficits after neurosurgically treated CTBI, also with the newer neurosurgical concept. Verbal learning and the executive control over memory functions should be addressed with interventions aimed at restoration, coping and compensation.
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| 2. |
- Aaro Jonsson, Catherine, 1963-, et al.
(författare)
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Neuropsychological progress during 14 years after severe traumatic brain injury in childhood and adolescence
- 2004
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Ingår i: Brain Inj. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 18:9, s. 921-34
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the impact of time since injury on neuropsychological and psychosocial outcome after serious TBI in childhood or adolescence. METHODS: The subjects were eight patients with serious TBI sustained at a mean age of 14 years who had been assessed neuropsychologically at 1, 7 and 14 years after TBI. A retrospective longitudinal design was chosen to describe the development in six neuropsychological domains on the basis of the assessments. Psychosocial data were gathered from clinical knowledge and a semi-structured interview 14 years after TBI. RESULTS: Performance of verbal IQ shows a declining trend over the three assessments, that the performance of attention and working memory is low and that verbal learning is the cognitive domain which exhibits the largest impairments. The main psychosocial result is that three of the eight subjects went from a school situation with no adjustments to adult life with early retirement. CONCLUSIONS: Time since insult is an important factor when assessing outcome after TBI in childhood and adolescence and that assessment of final outcome should not be done before adulthood.
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| 5. |
- Allely, Clare Sarah
(författare)
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Prevalence and assessment of traumatic brain injury in prison inmates: A systematic PRISMA review
- 2016
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Ingår i: Brain Injury. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 30:10, s. 1161-1180
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The primary objectives of the present systematic PRISMA review were: (1) to explore the range of prevalence of TBI in offenders and whether this is higher than in a control sample; (2) to determine which screening measures are available and evaluate the evidence on these; and, lastly, (3) to evaluate whether prevalence of TBI is associated with increased prevalence of other health conditions and/or offending behaviour. Methods: The present systematic PRISMA review explores the peer-reviewed literature published since 2005 which has investigated TBI in incarcerated populations using five databases (CINAHL, MEDLINE, PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO) in addition to separate searches conducted on ‘Google Scholar’ using specific search criteria. Results: Seventeen studies were identified which explored the prevalence of TBI in inmates. Only five of the seventeen studies which investigated prevalence of TBI in offender populations looked at juvenile offending. Interestingly, only seven of the 17 studies included both male and female samples (two of which did not report findings separately for males and females). In terms of the assessments used to investigate prevalence, three studies investigated the prevalence of TBI using The Ohio State University (OSU) TBI Identification method (OSU-TBI-ID). Nine studies used one or two questions in order to elicit information on whether the offender had previously experienced a TBI. Only two studies used the Traumatic Brain Injury Questionnaire (TBIQ). One study used the Brain Injury Screening Index (BISI). One study investigated patients discharged from non-federal South Carolina Emergency Departments or hospitals with a TBI-related ICD-9-CM code. Lastly evidence of TBI checklist from medical record (14 items) was used in one study. Conclusions: In terms of the implication for further research and practice, the studies identified in this review clearly emphasize the need to account for TBI in managing care in offender populations, which may contribute to reduction in offending behaviours. Additionally, there is a need for further research investigating the clinical utility of screening tools for detecting TBI in offender populations such as The Traumatic Brain Injury Questionnaire (TBIQ), The Brain Injury Screening Index (BISI) and The Ohio State University (OSU-TBI-ID) TBI Identification method. © 2016 Taylor & Francis Group, LLC.
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| 6. |
- Appelros, Peter, et al.
(författare)
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Comorbidity in stroke survivors in a medium-sized Swedish municipality
- 2023
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Ingår i: Brain Injury. - : Informa Healthcare. - 0269-9052 .- 1362-301X. ; 37:Suppl. 1, s. 135-136
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: The purpose of this study was to evaluate the prevalence and impact of stroke-related comorbidity in a community-based sample of stroke survivors. With respect to the patients’ functional outcomes and general health, we wanted to find out which types of comorbidity were most important.Materials and Methods: All stroke survivors (n = 330) living in a medium-sized Swedish municipality were included. To determine the presence of comorbidities patient records were reviewed. A selection of patient reported outcomes were used to assess subjective symptoms, functional outcomes, and general health. All patients were asked to answer a questionnaire, the Swedish Stroke Register (Riksstroke). Three questions from the questionnaire were used as additional measures of comorbidity. “Do you feel tired?,” “Do you have pain?” and “Do you feel depressed?” As outcome measures the patient reported measures from the Riksstroke questionnaire were used: * Do you still have problems after your stroke? * Have you been able to return to the life and activities you had before the stroke? * How is your mobility now? * Do you get help from someone when visiting the toilet? * Do you get help with dressing and undressing? * How do you assess your general health? Logistic regression models were used to investigate the association between comorbidities, residual symptoms, and subjective symptoms on the one hand, and functional outcomes and general health on the other hand.Results: Hypertension (80%) was the most common cardiovascular risk factor. Ischemic heart disease was found in 18% and congestive heart failure in 10%. Of non-cardiovascular disorders, orthopedic diseases were commonest (30%). Psychiatric disorders and cognitive impairment were present in 11% and 12% respectively. Logistic regression analyses found that hemiparesis was associated with both poorer functional outcomes and lower general health. Additionally, orthopedic disorders, vertigo, cognitive impairment, nicotine use, chronic pulmonary disorders, and older age, were also associated with poorer functional outcomes. Psychiatric, orthopedic and neurological disorders were associated with poorer general health. The patient-reported outcome measure “feeling of tiredness” was a predictor of both outcomes, while “feeling depressed” and “having pain” were associated with poorer general health.Conclusions: Many medical conditions, several of which have received little attention so far, are associated with poorer functional outcome and lower general health among stroke survivors. Future research into comorbidities relevant to function and general health in stroke patients could further focus on these disorders that hitherto have received little attention.
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| 8. |
- Bazarian, Jeffrey J, et al.
(författare)
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Serum S-100B and cleaved-tau are poor predictors of long-term outcome after mild traumatic brain injury.
- 2006
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Ingår i: Brain Injury. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 20:7, s. 759-65
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Tidskriftsartikel (refereegranskat)abstract
- PRIMARY OBJECTIVE: To determine the relationship of serum S-100B and C-tau levels to long-term outcome after mild traumatic brain injury (mild TBI). RESEARCH DESIGN: A prospective study of 35 mild TBI subjects presenting to the emergency department. METHODS AND PROCEDURES: Six hour serum S-100B and C-tau levels compared to 3-month Rivermead Post Concussion Questionnaire (RPCQ) scores and post-concussive syndrome (PCS). MAIN OUTCOMES AND RESULTS: The linear correlation between marker levels and RPCQ scores was weak (S-100B: r = 0.071, C-tau: r = -0.21). There was no statistically significant correlation between marker levels and 3-month PCS (S-100B: AUC = 0.589, 95%CI. 038, 0.80; C-tau: AUC = 0.634, 95%CI 0.43, 0.84). The sensitivity of these markers ranged from 43.8-56.3% and the specificity from 35.7-71.4%. CONCLUSIONS: Initial serum S-100B and C-tau levels appear to be poor predictors of 3-month outcome after mild TBI.
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| 9. |
- Berger-Estilita, Joana, et al.
(författare)
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A new global health outcome score after trauma (GHOST) for disability, cognitive impairment, and health-related quality of life: data from a prospective cross-sectional observational study
- 2019
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Ingår i: Brain Injury. - : Informa Healthcare. - 0269-9052 .- 1362-301X. ; 33:7, s. 922-931
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Tidskriftsartikel (refereegranskat)abstract
- Background:Trauma patients experience morbidity related to disability and cognitive impairment that negatively impact their health-related quality of life (HRQoL). We assessed the impact of trauma on disability, cognitive impairment and HRQoL after intensive care in patients with and without traumatic brain injury (TBI) and created a predictive score to identify patients with worse outcome. Methods:We identified 262 patients with severe trauma (ISSamp;gt;15) admitted to the emergency room of a level 1 trauma center. Patients above 13 years were included. After 6 months, patients were assessed for disability, cognitive impairment, and HRQoL. A global health outcome score after trauma (GHOST) was obtained through the combination of these domains. Logistic regression analysis was considered for the effect of demographic, trauma and hospital factors on global outcome. p amp;gt; 0.05. Statistics performed with SPSS 23.0. Results:Patients with the worst outcomes were older and had a longer length of Intensive Care Unit (ICU) stay. The effect of gender was found in all "GHOST dimensions". TBI was not significantly associated with worse outcome. Conclusions:No significant differences were seen on disability, cognitive impairment and decreased HRQoL in patients with or without TBI. Our GHOST score showed that female gender, older age, and longer ICU stay were significantly associated with the worst outcome. Abbreviations: AIS: Abbreviated Injury Scale; EQ-5D: EuroQol 5-dimensions; EQ-5D-3L: EuroQol 5-dimensions 3-levels; GCS: Glasgow Coma Scale; GOSE: Glasgow Outcome Scale Extended; HRQoL: Health-Related Quality of Life; ICU: Intensive Care Unit; ISS: Injury Severity Score; MMS: Mini Mental State; NICE: National Institute for Health and Care Excellence; RTS: Revised Trauma Score; TBI: Traumatic brain injury; TRISS: Trauma Injury Severity Score; VAS: Visual Analogue Scale.
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| 10. |
- Berginström, Nils, 1984-, et al.
(författare)
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Fatigue after traumatic brain injury is linked to altered striato-thalamic-cortical functioning
- 2017
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Ingår i: Brain Injury. - : Taylor & Francis. - 0269-9052 .- 1362-301X. ; 31:6-7, s. 755-755
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Tidskriftsartikel (refereegranskat)abstract
- Mental fatigue is a common symptom in the chronic phase of traumatic brain injury. Despite its high prevalence, no treatmentis available for this disabling symptom, and the mechanisms underlying fatigue are poorly understood. Some studies have suggested that fatigue in traumatic brain injury and other neurological disorders might reflect dysfunction within striato-thalamic-cortical loops. In the present study, we investigated whether functional magnetic resonance imaging(fMRI) can be used to detect chronic fatigue after traumatic brain injury (TBI), with emphasis on the striato-thalamic cortical-loops. We included patients who had suffered traumatic brain injury (n = 57, age range 20–64 years) and experienced mental fatigue > 1 year post injury (mean = 8.79 years, SD = 7.35), and age- and sex-matched healthycontrols (n = 27, age range 25–65 years). All participants completed self-assessment scales of fatigue and other symptoms, underwent an extensive neuropsychological test battery and performed a fatiguing 27-minute attention task (the modified Symbol Digit Modalities Test) during fMRI. Accuracy did not differ between groups, but reaction times were slower in the traumatic brain injury group (p < 0.001). Patients showed a greater increase in fatigue than controls from before to after task completion (p < 0.001). Patients showed less fMRI blood oxygen level–dependent activity in several a priori hypothesized regions (family-wise error corrected,p < 0.05), including the bilateral caudate, thalamus and anterior insula. Using the left caudate as a region of interest and testing for sensitivity and specificity, we identified 91% of patients and 81% of controls. As expected, controls showed decreased activation over time in regions of interest—the bilateral caudate and anterior thalamus (p < 0.002, uncorrected)—whereas patients showed no corresponding activity decrease. These results suggest that chronic fatigue after TBI is linked to altered striato-thalamic-cortical functioning. The high precision of fMRI for the detection of fatigue is of great clinical interest, given the lack of objective measures for the diagnosis of fatigue.
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